Fri Nov 04 2022

89 articles - From Friday Oct 28 2022 to Friday Nov 04 2022

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…

Am J Gastroenterol

A Stitch in Time: Rethinking the Rationale for Empiric PPIs in the ACG GERD Guideline.

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Endoscopy

Using New Hampshire Colonoscopy Registry Data to Assess the US and ESGE Post Polypectomy Surveillance Guidelines.

Performance characteristics for the ESGE and USMSTF recommendations are similar in predicting metachronous advanced neoplasia and long term CRC. Furthermore, the addition of risk groups such as the USMSTF 5-10/3-5 year groups to the USMSTF 3 year category did not alter the PPV or NPV significantly.

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Meta-analysis

meta-analyses and systematic reviews


Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Cannabinoid hyperemesis syndrome in North America: evaluation of health burden and treatment prevalence.

Survey data suggest patients with CHS almost universally suffer from a cannabis use disorder, which has significant treatment implications. Treatment prevalence in the ED has increased substantially over a very short time period, with the highest rates seen during the Covid-19 pandemic.

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Impact of potent nucleos(t)ide therapy on hepatitis B hospitalisations in Spain.

Hospital admissions of individuals with HBV infection are increasing in Spain. While hepatic decompensation events declined following the introduction of potent oral nucleos(t)ide therapy, HBV-related liver cancer is rising. No benefit of oral antiviral therapies is seen on hepatitis delta.

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Intestinal ultrasound detects an increased diameter and submucosal layer thickness in the appendix of patients with ulcerative colitis compared to healthy controls - a prospective cohort study.

A TAD =6mm was predominantly seen in A-UC. TAD was higher in UC patients compared to HC irrespective of disease activity and was characterised by an increased submucosal layer thickness. IUS therefore has the potential to identify UC patients with appendiceal inflammation.

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Randomised clinical trial: comparison of tegoprazan and lansoprazole as maintenance therapy for healed mild erosive oesophagitis.

Tegoprazan 25mg was non-inferior to lansoprazole 15mg in maintenance of healing of mild EE. In this study, tegoprazan had a similar safety profile to lansoprazole.

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Randomised clinical trial: effects of MD-7246 on irritable bowel syndrome with diarrhoea.

MD-7246 at the doses studied did not improve abdominal pain relative to placebo in an IBS-D patient population. Similarly, most additional efficacy endpoints showed no improvement with MD-7246 relative to placebo.

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Real world population pharmacokinetic study in children and young adults with inflammatory bowel disease discovers novel blood and stool microbial predictors of vedolizumab clearance.

This novel paediatric vedolizumab pharmacokinetic model could inform precision dosing. While additional studies are needed, an abundance of faecal butyrate producers is associated with early response to vedolizumab, suggesting that microbial analysis may be beneficial to biological selection.

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Significant histological disease of patients with chronic hepatitis B virus infection in the grey zone.

Over 70% of GZ CHB patients had significant histological disease. We recommend antiviral treatment for HBeAg-positive and HBeAg-negative GZ CHB patients with high PT.

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Systemic and T cell-associated responses to SARS-CoV-2 immunisation in gut inflammation (STAR SIGN study): effects of biologics on vaccination efficacy of the third dose of mRNA vaccines against SARS-CoV-2.

Anti-TNF-treated IBD patients have impaired humoral and cellular immunogenicity following SARS-CoV-2 booster vaccination. Fourth dose administration may be beneficial for these patients.

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Am J Gastroenterol

A Randomized, Dose-Finding, Proof-of-Concept Study of Berberine Ursodeoxycholate in Patients With Primary Sclerosing Cholangitis.

HTD1801 is associated with significant improvement in ALP and warrants further study as a treatment for PSC.

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A Reappraisal of the Diagnostic Performance of B-Mode Ultrasonography for Mild Liver Steatosis.

B-USG was an effective, objective method to detect mild liver steatosis using MRI-PDFF as comparison, regardless of the etiologies and comorbidities.

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Berberine Ursodeoxycholate for the Treatment of Primary Sclerosing Cholangitis: The Search for the Elusive Pharmacologic Holy Grail Will Need to Continue.

Although improvement in serum alkaline phosphatase is reported, without a control arm with UDCA monotherapy, it is not possible to determine whether this study drug is beneficial over UDCA by itself. More study in the PSC therapeutic arena is needed.

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Gastroesophageal Reflux Disease Is Not a Great Screening Criterion: Time to Move on to Other Strategies for Controlling the Burden of Esophageal Adenocarcinoma.

This is likely due to a conflation among providers regarding diagnostic EGD in those with refractory symptoms and screening EGD. An alternative approach is needed that de-emphasizes GERD to avoid confusion and increase uptake of appropriate screening.

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Inflammatory Bowel Disease-Associated Colorectal Cancer Epidemiology and Outcomes: An English Population-Based Study.

IBD-associated CRCs occur in younger patients and have worse outcomes than sporadic CRCs. There is an urgent need to find reasons for these differences to inform screening, surveillance, and treatment strategies for CRC and its precursors in this high-risk group.

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Longitudinal Associations of Risk Factors and Hepatocellular Carcinoma in Patients With Cured Hepatitis C Virus Infection.

Risk factors for HCC were different in patients with and without cirrhosis and some also evolved during follow-up. These factors can help with risk stratification and HCC surveillance decisions in patients with cured HCV.

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Clin Gastroenterol Hepatol

Linked-color imaging detects more colorectal adenoma and serrated lesions: an international randomized controlled trial.

Compared to WLI, LCI improved adenoma and other polyps' detection rates, including SSLs, resulting in alteration of the recommended surveillance schedule after screening, diagnostic, and post-polypectomy surveillance colonoscopy.

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Role Of Oral Health, Frailty and Minimal Hepatic Encephalopathy In The Risk Of Hospitalization: A Prospective Multi-Center Cohort Of Outpatients with Cirrhosis.

CONCLUSIONS: In a contemporaneous prospective, multi-center cohort study in outpatients with cirrhosis, poor oral health is significantly associated with 3-month hospitalizations independent of portal hypertensive complications, MHE and frailty. Potential strategies to reduce hospitalizations should consider oral evaluation in addition to MHE and frailty assessment in practice pathways.

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Endoscopy

A NOVEL THROUGH-THE-SCOPE HELIX TACK AND SUTURE DEVICE FOR MUCOSAL DEFECT CLOSURE FOLLOWING COLORECTAL ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD): A MULTICENTER STUDY.

TTSS is an effective and safe tool for the closure of large mucosal defects after colorectal ESD and is an alternative when complete closure with TTSC alone is not possible.

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Accurate prediction of histological grading of intraductal papillary mucinous neoplasia using deep learning.

This pilot study demonstrates that deep learning in IPMN-EUS images can predict the histological outcome with high accuracy.

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Advanced serrated polyps as target of screening: detection rate and positive predictive value within a fecal immunochemical test based colorectal cancer screening population.

A proportion of 5.9% FIT-positive screenees had ASPs, but half of these were detected in combination with CRC or AA. Therefore, including ASPs results in a small increase in the yield of FIT-based screening.

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Gastrointest Endosc

Impact of margin thermal treatment after endoscopic mucosal resection of giant (= 40 mm) colorectal lateral spreading lesions.

STSC treatment after pEMR of large lateral spreading lesions in the colorectum reduced recurrences by 75%. However, the absolute recurrence rate of 9% remained clinically significant in the STSC treated group. Short term follow-up after STSC of lesions = 40 mm is still warranted, and additional study of technical factors that eliminate recurrence after pEMR of giant lateral spreading lesions is warranted.

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Impact of peroral endoscopic myotomy on high-resolution manometry findings and their association with the procedure's outcomes.

Extended gastric myotomy decreased IRP values, while peristalsis recovery depended on the characteristics of achalasia. A residual high post-POEM IRP does not necessarily mean clinical failure. Routine HRM follow-up is not recommended after POEM.

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Prophylactic EUS-guided gallbladder drainage prevents acute cholecystitis in patients with malignant biliary obstruction and cystic duct orifice involvement: A randomized trial (with video).

In this single center study of patients with unresectable MBO and occlusion of the cystic duct orifice, prophylactic EUS-guided gallbladder drainage demonstrated a reduced incidence of acute cholecystitis.

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The effect of ursodeoxycholic acid following self-expandable metallic stent placement in malignant distal biliary obstruction: A propensity score-matched cohort analysis.

Administering UDCA after SEMS was not efficacious for prolonging the TRBO in MDBO. Moreover, administering UDCA beyond a month might increase the risk of stent sludge occlusion.

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Underwater versus Conventional Endoscopic Mucosal Resection for Non-Pedunculated Colorectal Lesions: A Randomized Clinical Trial.

This study demonstrated that UEMR was associated with lower adenoma recurrence rate than CEMR. Both endoscopic techniques are effective and have similar rates of adverse events for the treatment of non-pedunculated colorectal lesions.

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Gut

Engineered anti-PDL1 with IFNa targets both immunoinhibitory and activating signals in the liver to break HBV immune tolerance.

Targeting the liver with an engineered anti-PDL1-IFNa heterodimer can break HBV-induced immune tolerance to an HBsAg vaccine, offering a promising translatable therapeutic strategy for the functional cure of CHB.

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Irritable bowel syndrome: treatment based on pathophysiology and biomarkers.

These advances augur well for the implementation of evidence-based individualised treatment for patients with IBS based on actionable biomarkers or psychological disturbances.

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Rates of repeated colonoscopies to clean the colon from low-risk and high-risk adenomas: results from the EPoS trials.

There is considerable practice variation in the number of colonoscopies performed to achieve complete polyp removal, indicating need for targeted quality improvement to reduce patient burden.

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Use of over-the-scope clip (OTSC) versus standard therapy for the prevention of rebleeding in large peptic ulcers (size =1.5 cm): an open-labelled, multicentre international randomised controlled trial.

The routine use of OTSC as primary haemostasis in large bleeding peptic ulcers was not associated with a significant decrease in 30-day rebleeding.

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J Hepatol

Prognostic and therapeutic significance of microbial cell-free DNA in plasma of people with acutely decompensated cirrhosis.

The results of this study suggests that NHVs may have a pathogenic role in complicating the course of AD. Further validation is needed to define whether this should be incorporated in the routine management of AD patients. Impact and implications Cirrhosis patients with acute decompensation have a non-hepatotropic virus (NHV) signature, which is similar to that in sepsis and hematological malignancies patients. The detected viral signature had clinical correlates, including clinical efficacy of empirical antibiotic treatment, progression to acute-on-chronic liver failure and short-term mortality. The treatable NHV, CMV reactivation may be involved in the clinical outcomes of decompensated cirrhosis. Routine screening for NHVs, especially CMV, may be useful for the management of patients with acutely decompensated cirrhosis.

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Treatment of HCC with Claudin-1 specific antibodies suppresses carcinogenic signaling and reprograms the tumor microenvironment.

Our results provide the rationale for targeting CLDN1 in HCC and pave the way to novel therapeutic interventions with CLDN1 mAbs aimed at improving the limited efficacy of current therapies. Impact and implications Hepatocellular carcinoma (HCC) is a cancer with high mortality and unsatisfactory treatment options. Here we identified the cell surface protein Claudin-1 as a target for treatment of advanced HCC. Monoclonal antibodies targeting Claudin-1 inhibit tumor growth in patient-derived ex vivo and in vivo models by modulating signaling, cell stemness and the tumor immune microenvironment. Given the differentiated mechanism of action, the identification of Claudin-1 as a novel therapeutic target for HCC provides an opportunity to break the plateau of limited treatment response. These results of this preclinical study pave the way for the clinical development of Claudin-1 specific antibodies for treatment of HCC in patients. It is therefore of key impact for physicians, scientists and drug developers in the field of liver cancer and GI oncology.

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Neurogastroenterol Motil

From Chicago classification v3.0 to v4.0: Diagnostic changes and clinical implications.

While motility disorders diagnoses remained mainly unchanged with both CC, IEM was less frequent with CCv4.0 compared to CCv3.0. The higher GERD-Q score in IEM patients with CCv4.0 suggests that CCv4.0 might identify IEM more likely associated with GERD.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Microbial manipulation as therapy for primary sclerosing cholangitis.

The gut-liver axis is increasingly considered a potential target for the treatment of PSC. However, no therapies have been demonstrated to improve transplant-free survival. Innovative and well-designed clinical trials of microbiome-targeted therapies with long-term follow-up are required for this orphan disease.

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Clin Gastroenterol Hepatol

Blue Notes.

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Identifying Care Challenges as Opportunities for Research and Education in Inflammatory Bowel Disease in South Asia.

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Gastroenterology

Gut Microbiota Modulation of Efficacy and Toxicity of Cancer Chemotherapy and Immunotherapy.

The objective of this review is therefore to outline the current knowledge on oncological pharmacomicrobiomics and to describe how the multiparametric functions of the gut microbiome influence treatment response across cancer types. The secondary objective is to propose innovative approaches for modulating the gut microbiome in clinical environments which improve therapy efficacy and diminish toxic effects derived from anti-neoplastic agents for patient benefit.

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J Hepatol

Radiological endpoints as surrogates for survival benefit in Hepatocellular Carcinoma trials: all that glitters is not gold.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

An Ulcerative Lesion in the Mid-Esophagus.

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Calendar of Courses, Symposiums and Conferences.

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Correction to: Biochemical Diagnosis of Bile Acid Diarrhea: Prospective Comparison With the 75Seleno-Taurohomocholic Acid Test.

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Response to Graham.

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Response to Rajendra.

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Clin Gastroenterol Hepatol

HYPERVIGILANCE AND ANXIETY ARE ELEVATED AMONG PATIENTS WITH LARYNGEAL SYMPTOMS WITH AND WITHOUT LARYNGOPHARYNGEAL REFLUX.

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Endoscopy

A novel elastic ring for suturing colonic anastomotic fistula by colonoscopy.

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A novel technique of intraductal ultrasonography using a newly designed endoscopic sheath and Y-connector during endoscopic retrograde cholangiography.

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Artificial intelligence for detecting and delineating a small flat-type early esophageal squamous cell carcinoma under multimodal imaging.

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Author commentary on Abdulbaqi Al-Toma et al.

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Author commentary on Judith A. Kwakman et al.

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Author commentary on Mark A. Gromski et al.

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Author commentary on Noriko Nishiyama et al.

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Author commentary on Roy L. J. van Wanrooij et al.

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Author commentary on Victoria Arthursson et al.

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Endoscopic full-thickness resection with reconstruction of the rectal wall.

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Endoscopic ligation technique with O-ring closure: improved or complicated?

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Endoscopic management of gastrojejunocolic fistula as an unusual complication of endoscopic ultrasound-guided gastroenterostomy.

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Endoscopic submucosal dissection combined with underwater endoscopic mucosal resection for rapid treatment of multiple early esophageal cancers.

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Endoscopic submucosal dissection in the colon with adaptive traction device: resection strategy and device setup.

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Endoscopic treatment of a postoperative anastomotic stricture in a patient with refractory Crohn's disease.

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Endoscopic ultrasound-guided antegrade stenting for benign biliary disease in an elderly patient with altered anatomy (Roux-en-Y).

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Endoscopic ultrasound-guided antegrade stenting using a novel flower-type fully covered self-expandable metal stent.

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Endoscopic ultrasound-guided drainage of a splenic abscess using lumen-apposing metal stent.

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Eradication of angiomas by nylon loop snare ligation under total enteroscopy, in disseminated intravascular coagulation associated with blue rubber bleb nevus syndrome.

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Laser lithotripsy to treat a huge incarcerated esophageal bezoar.

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Lost in the tunnel: Submucosal tunneling endoscopic resection guided by endoscopic ultrasound coils.

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Measuring polyp size using a virtual scale endoscope: a video tutorial with clinical case demonstration.

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Multifocal ulcerating stenosing enteritis as a novel manifestation of immunoglobulin G4-related disease.

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New image-enhanced cholangioscopy for the diagnosis of cholangiocarcinoma.

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Portobiliary fistula on single-operator cholangioscopy.

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Preemptive purse-string suturing technique-assisted endoscopic papillectomy of ampullary adenoma.

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Reply to Wu et al.

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Successful endoscopic ultrasound-guided hepaticogastrostomy with use of a novel drill dilator for challenging tract dilation.

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Transabdominal esophago-cutaneous fistula closure with endoscopic negative pressure therapy using a thin open-pore film drain in a pull-through technique.

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Tunneling technique using a device delivery system for the treatment of pancreaticopleural fistula due to severe downstream pancreatic duct strictures.

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Underwater endosonography (uEUS) for enhancement of small mucosal and submucosal gastrointestinal lesions.

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Gastroenterology

Comparative Performance of Artificial Intelligence Optical Diagnosis Systems for Leaving-In-Situ Colorectal Polyps.

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Gastrointest Endosc

Impact of margin ablation after Endoscopic Mucosal Resection of large non pedunculated colonic polyps in routine clinical practice.

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Gut

Going deeper: molecular inflammatory scores in IBD.

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Picking up microbial clues in early-onset colorectal cancer.

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Letters&Replies

Letters to the editors and authors’ replies

Clin Gastroenterol Hepatol

Similar cure rates with different routes. Can it be generalized?

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Gastroenterology

Colorectal ESD: not a case of one size fits all.

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Serotonin in gastrointestinal disorders: delineating peripheral versus central effects.

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Gut

APC mosaicism, not always isolated: two first-degree relatives with apparently distinct APC mosaicism.

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On the ethics of digestive health research in historically marginalised communities.

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Overcoming regional limitations: transfer learning for cross-regional microbial-based diagnosis of diseases.

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Reply to Newman et al 'Response to epidemiology of inflammatory bowel disease in men with high-risk homosexual activity'.

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J Hepatol

Detection of unreported alcohol consumption in fatty liver disease.

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Life's Essential 8 and MAFLD in the United States.

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NAFLD was independently associated with severe COVID-19 among younger patients rather than older patients: A meta-analysis.

Pubmed   Journal   ReadQx   PMC